Experience with Doctors and Pharmacists

September 10, 2022

In late August at the cottage, I had a few cups of black coffee before breakfast. Soon after finishing my coffee, I felt queasy and dizzy. I had to lie down to get my mojo back; it took a few hours to get rid of the dizziness.

The next unpleasant experience occurred during the drive home from the cottage, when I suddenly felt like blacking out, with my vision blurring and experiencing weakness. It took a few deep yoga breaths to get my composure back. Fortunately, I was on the passenger side.

These scary experiences led me to an urgent visit to my medical clinic. There, the nurse practitioner gave me requisitions for blood testing, a Holter monitor (heart monitor) for seventy-two hours, a stress test and an ECG.

The next morning, I still felt dizzy and that made me go to an emergency room (ER) where they put me thru a thorough blood test, urine test and an ECG. After six hours the emergency doctor gave me a clean bill of health and suggested that I follow up with my family doctor should I continue to experience dizziness.

If my heart is all right, what might cause the morning dizziness (by the afternoons the dizziness subsided)? I became suspicious of one new pill I take, prescribed for me a few months ago, and I stopped at my pharmacist to check if some of the meds I take may work against this new pill. The pharmacist found this pill contradicts in its effect with another one I take and recommended a change to one of them. The next day I saw the prescribing doctor, who immediately agreed with the pharmacist’s  advice and gave me a substitution, another pill.

In some ways I was stunned the doctor did not question the advice from the pharmacist at all: but it made me think, do doctors know and understand what they prescribe? What damage could wrong prescriptions cause to patients?

My appreciation for pharmacists went up a few notches; they are knowledgeable of pharmaceuticals and decided that they know more about meds than doctors.

Based on the results of my visit to the ER, we decided to follow up on our vacation plan to go to Myrtle Beach, SC, and meet with family for a few days. It was a two-day trip, and we enjoyed the vacation until I received an email to phone my medical office immediately. When I contacted them, they told me to go to an emergency department ASAP. It was a terrible downer for me, and I asked what the cause or the reason was for going to ER, ASAP. I explained that I was in South Carolina and despite my Canadian medical insurance, it could be an expensive affair. I talked with a nurse at the clinic who did not know why I should go to ER immediately but promised to email the doctor to find out the reason: what was I going to say to the local ER, what was wrong with me which brought me to ER?

The nurse responded by email in an hour, and repeated that I should go to ER and attached two reports and told me to print them out to take with me – the results of the ECG and the results of the Holter report. We consulted with two acquaintances, both doctors, one is an ER doctor, and sent them the Holter report and the ECG, which they found not super urgent to attend to.

Confused by all these views, we decided to see how I felt the next day and still feeling bad in the morning we decided to drive home.

The next phase of my adventure was even more strange; we went to a different hospital ER in Ottawa, where I went thru all the testing again only to be told the Holter and ECG reports did not justify leaving our vacation early. This ER doc consulted with a cardiologist, so the news I received was very comforting to me.

So, what do I make of all of this when my family doctor says I am in dire need to visit an ER and two other docs and a second ER visit give me a clean bill of health? One must conclude that the medical advice from my clinic was misguided or plain wrong. Perhaps the attending doctor on duty at my family clinic was not fully knowledgeable how to interpret Holter monitoring results?  But why did he/she not call me to explain why my situation was bad? Is this expecting too much?

But, if I had gone to a local ER in the U.S. and if they had found my visit unnecessary, my insurance would not have paid for the visit, potentially costing me thousands of US dollars. And it may have given me a black mark in my record for future travel insurance, having a heart issue identified, even if it was wrong.

I think it was wrong of the attending doctor at my clinic not to check with other doctors or a cardiologist before ordering me to visit an ER, ASAP.   But, perhaps more importantly, he should have communicated in person, by phone, to tell me the “dire” news.

Although I felt much better being at home, I still felt a bit weak the next few days in the mornings, and now I was beginning to suspect that it must be my meds that are the problem, since I was fully examined and tested in two ERs over a two week period. So, what do I do? I looked at my meds again and talked to two pharmacists to check out how my meds may interfere with each other and what side effects they may have.

Both pharmacists immediately identified that I should not take two of my pills at the same time and suggested that I take one in the morning and the other in the evening. Not rocket science if you know your pharmaceuticals.

Lessons learned: do not immediately believe what your doctors tell you; ask for explanations. And check with your pharmacist regarding your pills. My appreciation for pharmacists had jumped astronomically after these recent experiences with them.

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